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Editorial Friday 29 May 2015: Is Monitor's Dr David Bennett the new Jim Morrison, Shia LaBoeuf or Michael Heseltine?

Health Policy Insight spoils you, I know. Firstly, you got exclusive understanding of how Simon Stevens' NHS strategy is derived from Brian Wilson's Pet Sounds.

Now we can exclusively reveal that Dr David Bennett is the reincarnation of leather-trousered rock god and Doors frontman Jim Morrison.

As well as being the most pretentious rock star of the 1960s, Jim Morrison self-identified as a poet, and produced the lyrics that became 'Celebration Of The Lizard', in which Jimbo pronounced "I am the Lizard King/I can do anything".


And now Dr Bennett has revealed himself as Jimbo reincarnated, in this interview with HSJ's Crispin Dowler. He is the Lizard King, and he can do anything.

Jimbo Bennett can ensure that FTs in financial breach of their authorisation licence "will face tighter regulatory controls on their agency and management consultancy spending".

Yes, you read that right: this is the same Monitor which, when putting FTs into special measures, imposes management consultants on them - and is itself largely staffed by current or former management consultants, spending almost 20% of its budget on management consultancy.

And the same Monitor which sets the tariff that is driving many providers into deficit.

As Professor Bob Hudson pithily pointed out, Jimbo is 'pulling a Blatter' here: insisting that it falls to him to fix things.


Jimbo Bennett has also become exercised about agency staff costs. This has obviously got nothing to do with the government policy of holding down staff wages (and refusing to pay the last recommended increment) driving NHS staff to agency work to earn a living wage.

A farewell to free markets for agency staff
HSJ understands that there are concerted efforts at senior levels of the Conservative Government to seek to cap approved rates of agency staff.

It is comically instructive that free market proponents are surprised by the rational decisions of staff and agencies as efficient maximisers. The low supply of trained staff and extended period of wage restraint has the obvious effect of raising prices in the free market. Price ceilings don't have a glorious economic or political history when the fundamental problem is not one of high price, but rather one of low supply.

Quick note for the Government: this is what free markets do. It's not a bug; it's a feature.

Quick note for the Government (part two): if you try to act as a monopsony price-fixer, you'll probably be in breach of the 2002 Enterprise Act and the Competition and Markets Authority will probably notice. To market, to market, to buy a fat pig ... and of course to prevent anti-competitive behaviour in the NHS.

To better understand the issues here, it's well worth reading this blog by Andrew Taylor, former head of the NHS Co-Operation and Competitiion Panel. Andrew is a smart man, and suggests in his blog that Monitor could already do something about evidence of agency malefeasance, if there were any.

Andrew Taylor has followed this up with another blog on whether capping agency rates will save the NHS money. For the time-poor, his conclusion is 'not other than in the very short term'.

(Oh yes, whatever happened to "NHS Professionals is a limited company wholly owned by the Department of Health"?)

As if the new role as an arms-length-but-bearing-P45 economic regulator were not enough, Jimbo Bennett tells HSJ that he wants to "look at" redefining access targets to help deal with a squeeze on agency pay bills.

Nice concept, in theory. Shit idea in practice, for two main reasons:
1. Access targets are set down in the NHS Constitution, mandate and standard contract. Jimbo can look at them all he likes.
2. Making patients wait a bit longer can be clinically counter-productive, since unless they die or are miraculously cured, they still need the treatment. This just doesn't particularly save money. Besides, who knows what former Conservative health secretaries might have said about this?

Shia LaBoeuf, meet Michael Heseltine
Two possible explanations come to mind.

Perhaps Jimbo - Dr David Bennett is pulling a Shia LaBoeuf-style performance art piece, to draw attention to the major-league lunacy of the current situation. That's possible, at a long stretch.

The other, rather more worrying possibility is that he feels a need to be seen to be doing a Heseltine, and intervening before breakfast, lunch, tea and dinner to forestall Jeremy Hunt doing so instead. To this end, Jimbo wants the NHS to know that he is the Lizard King, and he can do anything.

Except he isn't. And he can't.

'Hey, look! Lots of FTs are in financial trouble!'
"Wow. I wonder what twat's been setting the tariff and driving scarce trained staff to agency working with five years of pay freezes.'

HSJ has another story about Monitor's plans for a successor to buddying, which in a stroke of genius is to be dubbed 'super-buddying'. Clearly, 'super-duper buddying'  is the logical next step, followed closely by 'supercalifragilisticexpialidocious buddying'.